# AnyCXR: Human Anatomy Segmentation of Chest X-ray at Any Acquisition Position using Multi-stage Domain Randomized Synthetic Data with Imperfect Annotations and Conditional Joint Annotation Regularization Learning

arXiv: https://arxiv.org/abs/2512.17263 · HTML: https://mlsanity.com/paper/2512.17263/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 17 of its 34 references that are in the map.
- First posted on arXiv 19 Dec 2025.

## Builds on (most cited first, 17 of 17)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [nnU-Net: Self-adapting Framework for U-Net-Based Medical Image Segmentation](https://mlsanity.com/paper/1809.10486/) (2018)
- [Generalist Foundation Models from a Multimodal Dataset for 3D Computed Tomography](https://mlsanity.com/paper/2403.17834/) (2024)
- [Deep Learning for Chest X-ray Analysis: A Survey](https://mlsanity.com/paper/2103.08700/) (2021)
- [TotalSegmentator MRI: Robust Sequence-independent Segmentation of Multiple Anatomic Structures in MRI](https://mlsanity.com/paper/2405.19492/) (2024)
- [Fast Auto-Differentiable Digitally Reconstructed Radiographs for Solving Inverse Problems in Intraoperative Imaging](https://mlsanity.com/paper/2208.12737/) (2022)
- [Detailed Annotations of Chest X-Rays via CT Projection for Report Understanding](https://mlsanity.com/paper/2210.03416/) (2022)
- [Accurate Fine-Grained Segmentation of Human Anatomy in Radiographs via Volumetric Pseudo-Labeling](https://mlsanity.com/paper/2306.03934/) (2023)
- [AnyStar: Domain randomized universal star-convex 3D instance segmentation](https://mlsanity.com/paper/2307.07044/) (2023)
- [Deep Learning Based Rib Centerline Extraction and Labeling](https://mlsanity.com/paper/1809.07082/) (2018)
- [Improving Classification Model Performance on Chest X-Rays through Lung Segmentation](https://mlsanity.com/paper/2202.10971/) (2022)
- [Deep Learning Models for Calculation of Cardiothoracic Ratio from Chest Radiographs for Assisted Diagnosis of Cardiomegaly](https://mlsanity.com/paper/2101.07606/) (2021)
- [Shadow and Light: Digitally Reconstructed Radiographs for Disease Classification](https://mlsanity.com/paper/2406.03688/) (2024)

## Built on by (most cited first, 2 of 2)

- [CheXanatomy: Anatomy-Aware Vision-Language Modeling for Chest Radiographs](https://mlsanity.com/paper/2606.08420/) (2026)
- [FleXray: Universal Clinical X-ray Segmentation](https://mlsanity.com/paper/2609.26756/) (2026)

## Abstract (arXiv)

Robust anatomical segmentation of chest X-rays (CXRs) remains challenging due to the scarcity of comprehensive annotations and the substantial variability of real-world acquisition conditions. We propose AnyCXR, a unified framework that enables generalizable multi-organ segmentation across arbitrary CXR projection angles using only synthetic supervision. The method combines a Multi-stage Domain Randomization (MSDR) engine, which generates over 100,000 anatomically faithful and highly diverse synthetic radiographs from 3D CT volumes, with a Conditional Joint Annotation Regularization (CAR) learning strategy that leverages partial and imperfect labels by enforcing anatomical consistency in a latent space. Trained entirely on synthetic data, AnyCXR achieves strong zero-shot generalization on multiple real-world datasets, providing accurate delineation of 54 anatomical structures in PA, lateral, and oblique views. The resulting segmentation maps support downstream clinical tasks, including automated cardiothoracic ratio estimation, spine curvature assessment, and disease classification, where the incorporation of anatomical priors improves diagnostic performance. These results demonstrate that AnyCXR establishes a scalable and reliable foundation for anatomy-aware CXR analysis and offers a practical pathway toward reducing annotation burdens while improving robustness across diverse imaging conditions.